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Generic Drugs Extend HIV Patients' Lives

Updated:
BANGKOK, Thailand (AP) _ A few years ago, HIV was like a death sentence for tens of thousands of Thais who couldn't afford expensive imported drugs. Then came hope, in the shape of a one-pill generic drug cocktail.

When the Thai Government Pharmaceutical Organization started producing the three-drug pill in March 2002, monthly treatment for one person plummeted to $30 from $500-$750.

Thailand is one of the few countries making generic anti-AIDS drugs after overcoming challenges by European and U.S. pharmaceutical giants in a global patent fight that raised the question: What is more important _ trade rules or people's lives?

The 146-nation World Trade Organization decided the latter, agreeing last September to allow poor nations to make copies of branded medicines to fight killer diseases in times of national health crises.

The use of generic drugs is a key topic at this week's International AIDS Conference in Bangkok, whose theme is ``Access to All,'' a reference to giving each person infected with HIV access to treatment. That is an estimated 42 million people around the globe, more than half of them in sub-Saharan Africa.

According to the World Health Organization, only 8 percent of those in need now receive drugs that in rich countries have turned AIDS from a death sentence into a chronic disease.

Until two years ago, members of his group ``were dying like leaves falling from a tree,'' said Kamol Upakaew, president and a founder of the Thai Network of People Living with HIV/AIDS.

Thailand woke up to its AIDS epidemic in 1991 when a record 142,819 infections were reported. In response, the government launched a nationwide program to raise awareness and to promote condom use.

In 1992, the Government Pharmaceutical Organization, started researching drugs that keep HIV under control.

Thailand expanded its free anti-AIDS pill program from 3,000 people to 10,000 in 2002 and to 50,000 people this year.

The program has made a visible difference, said Kamol, who has been an AIDS activist since he discovered he was infected with HIV in 1996.

``It changed from all our friends dying to: 'It's been two years now, and our friends are still here _ we're still alive,''' he said.

In a population of 63 million people, about 600,000 Thais have HIV now, 19,000 of whom were infected last year.

The patent fight began in 1998, when Thailand was about to produce an anti-AIDS pill based on the drug didanosine and Bristol-Myers Squibb sent a notice saying it had a patent on the medicine.

Thailand stopped the project, but it was urged by the Belgium-based Doctors Without Borders to fight the American pharmaceutical company.

So the Government Pharmaceutical Organization took the case to Thailand's Central Intellectual Property Court, which ruled the Bristol-Myers patent invalid in Thailand.

The October 2002 ruling also said charities and individuals could challenge patents on social grounds, such as public health. Previously, only companies with a commercial interest could file complaints.

Thailand now has expanded its treatment program by producing a single pill that contains the medicines stavudine, lamivudine and nevirapine _ a combination recommended by the WHO. The pill, taken twice daily, is easier for patients to keep up with than a regime that requires them to take three separate kinds of pill during a day.

The Government Pharmaceutical Organization, which makes six types of anti-AIDS medicines, supplies almost all its production to Thai hospitals, which are part of a national network giving free AIDS treatment.

Brazil, another big producer of generic anti-AIDS drugs, donates some pills to at least six African countries and plans to expand that to 14 nations this year. Generic drug companies in India also supply Africans with low-cost pills under an arrangement with the Clinton Foundation.

The Thai government plans to offer technological know-how to Africa, but for now must take care of its own because each year 40,000 to 50,000 more Thais need the pills, said Sombat Thanprasertsuk, director of the Thailand's AIDS bureau.

``This is a very big challenge because how can we cope with a high number of patients? We are trying very hard to look for even cheaper drugs,'' he said.
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